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Following the procedure

Her mother lived at home, but had a care assistant come round regularly so our friend knew her mother was in safe hands. A neighbour also checked occasionally.

She knew her mother was ill and was expecting her death to be sooner rather than later. So normally hearing about the death of your mother in these circumstances wouldn’t lead to a lot of stress and heartache as you would be prepared for it. In fact our friend had done so in terms of insuring that paper work etc was up to date.

However our friend was very upset and stressed out when she was told that her mother had died.

The first she heard about the deterioration of her mother’s health was one morning when the neighbour rang to say that her mother had not followed her usual routine and that when they knocked on the door there was no reply. So our friend rang the care assistant who went round to check.

The care assistant rang later that morning and said “Don’t worry too much, but your mother is not too well.” When asked specifically what the problem was the care worker reluctantly replied that “She’s not breathing, but don’t worry I’ve called the ambulance”. The care worker than rang off as the ambulance had arrived which left our friend in a bit of a state not knowing what to do or what was happening.

She waited a few minutes.

She didn’t live locally and it would take her over an hour to drive to her mother’s house. She rang the care assistant again to check what has happening. She was then told that the ambulance was taking her mother to hospital and that she would be informed what the result was when the doctors had seen her. Though not actually told that her mother was breathing she assumed the best since her mother was being taken to hospital. She then spent panicking about what to do. Should she wait for the hospital to ring or should she go to the hospital and see her mother in what was probably her last hours. But the hospital could ring whilst she was driving and if the news was bad would she be able to carry on driving.

So she decided to wait.

It was now late afternoon with no news, some time after her mother had been taken to hospital, so she rang the hospital to check on her mother’s situation. She was told that her mother was being seen to by the nurses. When asked if she should go to the hospital she was advised to “wait a bit till the doctor had seen her”.

So she waited some more.

A short time later she got a call from the hospital to let her know that her mother had died. By now our friend was in quite a state, what with the lack of information and the delays and being unable to see her mother.

What made our friend emotions even more raw was what she found out later when she spoke to the neighbour at the funeral.

What actually happened was that our friend’s mother had died in her sleep.

The care assistant couldn’t tell the daughter that her mother was dead as she was not allowed to say so which is why she said “she’s not breathing” and even that was not supposed to have been said.

The nurses couldn’t tell the daughter that her mother was dead as they were not allowed to say that someone is dead as they had to wait for the doctor to sign the death certificate before the could pass on the news. The doctor was busy so didn’t sign the certificate straight away which increased the delay till late afternoon.

The care worker, the ambulance medics, the nurses, and the doctor were all “following procedure”. What they were not doing is thinking of the other people involved in the situation. All they were concerned about was following procedure so that if anything went wrong they wouldn’t be penalised. The writer of the procedure is never penalised.

Many people in Britain now follow procedures rather than be given responsibility to act in a way that the situation requires. That’s not say that procedures are bad things, far from it. It helps people understand where they fit in to a bigger scheme, it helps train people, and it can ensure that steps are followed. But blindly following procedure to the exclusion of all else is stupidity.

Not taking responsibility is now the way to do your job. That’s because people are led to believe that if they do take responsibility for their actions and something goes wrong, they will lose their jobs or their organisation will be penalised which will affect their job prospects.

If the care worker could just have been allowed to just say that “Your mother is not breathing, I think she died in her sleep, but I’ve called the ambulance to make sure” then our friend would most likely have been comforted by the thought that her mother didn’t suffer. As it was she was led all along to believe that her mother must have been aware of what was happening as she was resuscitated and taken to hospital.

Old proverb, I think, springs to mind. Rules are for the guidance of the wise and for fools to follow. Unfortunately today we seem to have far to many fools or far too many people who are not prepared to step up to the mark and make a descision then stand by it.

In the old days nurses were allowed to use common sense. When I was a junior doctor, the good nurses would wait until I turned up on the ward in the morning to tell me someone terminal had died during the night – the less experienced ones or the ones with degrees would make me get up to decide if a patient was dead or not – it’s generally not that difficult to tell!

Be interesting to know whereabouts in the UK this incident took place as this situation wouldn’t normally arise. Ambulance crews don’t take dead people to hospital. Certainly in my patch paramedics can declare people ‘dead’ (recognition of life extinct) not to be confused with certifying death which only a doctor can do. We declare people dead, fill in the appropriate paperwork for the coroner and then the undertakers can be arranged. The coroner’s officer (police) are only contacted if the death is unexpected or suspicious, but either way the body is still left at home. The upshot of this is that we can, and do, notify relatives that their loved one has died. This week’s first instalment of Emergency with Angela Griffin on Sky 1 showed an ambulance crew from the West Midlands attending a person who had died at home. They did not convey him to the hospital.

Not exactly sure as I don’t know our friend’s mother’s location but Lancashire/Greater Manchester is the area. I got this story from my wife who got from our friend. So I’ve heard it third hand, or fourth hand if you count the neighbour as the source.

The situation was probably a bit confused taking into account our friend’s state of mind and that the care assistant was not passing on useful information.

Maybe the paramedics did manage to get some signs of life which meant that they could take her to hospital. But it was still follow the procedure rather than show any empathy with the people concerned.

“A Stalinist beaurocracy that has kept me alive for several years. Who knew I was attending a gulag?”

Yes, and its failing let many others not be so lucky.

The NHS provides a 40% survival rate for many types of cancer, where other western countries have 60%+. But as long as anyone survives the ‘left’ can pretend that the alternative to the NHS is no healthcare at all, and point a figure to that 40% and say ‘you libertarians who would remove the NHS would let that 40% die’. No we would not, we would let the market find the most efficient possible solution that would let another 20%+ live, and then they could post on blogs in defence of the healthcare they received as well, rather than being just a memory.

The NHS is our national shame, it is a blight on us all. Not for those it does actually save, but for all those it should be but cannot, because of its Stalinist dogma.

The NHS budget is £120 billion this year. That’s £2000 (near enough) for every man, woman and child in the country.

If you were paying £2000 per peson, per year in health insurance premiums, would you regard the service the NHS delivers as acceptable? I’m not sure that I would – I think the NHS can do much better than it is with that sort of money.

KingbingoMay 7, 2011 at 12:28

“If you can afford to pay.”

Yes Saul, because right now there is no NFS (National food service) and just look how many poor people are starving to death on our streets. Notice how Dozens of major food chains provided by the free market and literally thousands of independents simply do not exist. Right now the only people that eat in the absence of a NFS are rich people??????

No of course not. The state makes zero effort to feed people and the free market provides a myriad of choice at a level of quality service and price that a NFS could never in a million years come close to matching. I can’t believe how pervasive the brainwashing by the progressive element is that it has even actually convinced people who think of themselves as libertarians that the alternative of the state not doing something is that thing not being done at all.

The most the state should do is provide in its welfare payments money or credits ring fenced for health spending. But the state paying for a thing and the state actually attempting to provide a thing are very different. And don’t think that the tiny amount of private healthcare there currently is that you have to pay for twice is all there will ever be either, without the Stalinist NHS crushing the market there would be an explosion in healthcare providers. Most Tesco’s and Sainsbury’s store would add a GP clinic that would be walk in, low prices or low subscription like a mobile phone tariff. Access to health under the free market would be faster, cheaper, better, and a hell of a lot more people would still be alive.

How can anyone think of themselves libertarian and support the NHS, an organisation that lets so many die, just to be true to its socialist ideology. An organisation that makes us less wealthy, less healthy, less free to choose.

gladiolysMay 8, 2011 at 22:36

The WHO and OECD show that per £, we have better survival rates than a lot of other countries. Others measure survival rates from diagnosis. It depends on which measurements you choose. I think it shows we get good value for money – and if we spent more we would have better survival rates.

Cascadian: to call it a national death service is trite. I am still not dead, or would you wish it was successful under your definition? I know what a gulag is: it is a place where people were forced to go against their will. Gulags operated in Stalinist Soviet Union. Do you see why I used poetic licence to refer to the term in my earlier response?

Husband, “Doctor, my wife’s jaw has locked up and she can’t speak.” Doctor, “Hmmm. Sounds bad. I’ll pop out and see her tomorrow.” Husband, “Oh, there’s no rush, Doctor. Back end of next week will do fine.”

Sadly there is something few people realise: National Insurance is one massive Ponzi scheme.

What is currently being spent on healthcare now, your premiums, is in fact being used to service the healthcare needs of the previous generation of payees; the only one who didn’t have to worry about it – pensions or healthcare needs – were the first one when national insurance was instigated; naturally they were quite happy about getting lots of stuff for free with seemingly no catches.

Like all Ponzi schemes they will eventually collapse – it is likely we can thank Gordon Brown more than anyone for this; if he hadn’t been willing to hack off the taps on the spending faucet and let it coming gushing out.

What will in effect happen is that the preceeding generation to the one that eventually calls time on the entire scam will need caring for and this could play out in 2 ways: 1. we work out some sort of bridging scheme of funding for elderly care (higher than normal taxation with a view to end over 2 generations/roll up our sleeves and look after our old ourselves) or 2. the collapse leads to a period of fascism/socialism (dont care how they dress it at that time) where the elderly are viewed as “chaff” and treated as such.